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1. Allergic Bronchopulmonary Aspergillosis ABPA
2. Allergic Bronchopulmonary Aspergillosis
3. Aspergillosis Classification
4. Acute ABPA
5. Chronic ABPA
6. ABPA X-ray Appearance
7. ABPA X-ray Appearance
8. ABPA Diagnostic Criteria
Allergic Bronchopulmonary
Aspergillosis
ABPA
Allergic Bronchopulmonary
Aspergillosis
ABPA
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Allergic Bronchopulmonary
Aspergillosis
Hypersensitivity to aspergillus in
patients with long standing asthma
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Aspergillosis
Classification
Non-invasive aspergillosis
Fungus ball found in old TB cavity
Invasive pulmonary aspergillosis
Lymphoma/leukemia patients
Multiple nodules which may cavitate
Frequently fatal
Allergic bronchopulmonary aspergillosis
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Acute ABPA
Type I reaction
Immediate hypersensitivity (IgE-
mediated)
Histologically
Alveoli filled with eosinophils
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Chronic ABPA
Type III reaction
Delayed immune complex response=Arthus
reaction (IgG-mediated)
Histologically
Damage to bronchial wall
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ABPA
X-ray Appearance
Patchy, fleeting infiltrates
Usually in upper lobes
Thickened bronchial walls
“Finger-in-glove” “toothpaste shadow”
Mucus plugs in bronchi remain for months and
grow in size
Central bronchiectasis
Ring shadows around hilum
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ABPA
X-ray Appearance
Lobar consolidation (32%)
Atelectasis (14%)
Cavitation (14%)
Pulmonary fibrosis
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ABPA
Diagnostic Criteria
Asthma
Blood eosinophilia
Immediate skin rx to aspergillus
Elevated IgE
Central bronchiectasis
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